DIR. Endovascular management of bleeding events following robotic pancreaticobiliary surgery

To describe the utility, safety, and efficacy of endovascular intervention for treating bleeding events after robotic pancreaticobiliary surgery. Diagnostic and Interventional Radiology. January 2012 18:121–126. Copyright © Turkish Society of Radiology 2012

WJH. Transjugular intrahepatic porto-systemic shunt in the elderly: Palliation for complications of portal hypertension

AIM: To present a dedicated series of transjugular intrahepatic porto-systemic shunts (TIPS) in the elderly since data is sparse on this population group. World J Hepatol 2012 February 27; 4(2): 35-42 ISSN 1948-5182 (online). Copyright © 2012 Baishideng. All rights reserved.

WJG. Treatment of portal hypertension

Portal hypertension is the main complication of cirrhosis and is defined as an hepatic venous pressure gradient (HVPG) of more than 5 mmHg. Clinically significant portal hypertension is defined as HVPG of 10 mmHg or more. Development of gastroesophageal varices and variceal hemorrhage are the most direct consequence of portal hypertension. Over the last decades significant advancements in the field have led to standard treatment options. These clinical recommendations have evolved mostly as a result of randomized controlled trials and consensus conferences among experts where existing evidence has been reviewed and future goals for research and practice guidelines have been proposed. Management of varices/variceal hemorrhage is based on the clinical stage of portal hypertension. World J Gastroenterol 2012 March 21; 18(11): 1166-1175 ISSN 1007-9327 (print) ISSN 2219-2840 (online). cOPYRIGHT © 2012 Baishideng. All rights reserved.

DIR. Applications of the Amplatzer Vascular Plug 4

The purpose of this study was to present our initial experience with the Amplatzer ® Vascular Plug (AVP) 4 in various arterial environments. This material was designed for the embolization of peripheral small vessels using a diagnostic catheter. Herein, the following three procedures using the AVP 4 were described: hemodialysis fistula occlusion as a treatment for the steal phenomenon, gastroduodenal artery embolization prior to liver radioembolization, and vertebral artery embolization for the treatment of subclavian artery pseudoaneurysm and arteriovenous fistula. All of the treated vessels were successfully occluded, and the devices remained in the original locations and configurations during the follow-up period. When compared with the previous generation of vascular plugs, the AVP 4 allows faster and safer procedures with less radiation exposure to the patients and angiography team. Diagn Interv Radiol 2012; 18:225–230. Copyright © Turkish Society of Radiology 2012

DIR. Transcatheter embolization of congenital hepatic arteriovenous malformation using ethylene-vinyl alcohol copolymer (Onyx)

A male infant with high-output heart failure who had been found to have a hepatic arteriovenous malformation by ul- trasound imaging was referred to our center (Department of Diagnostic and Interventional Radiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Islamic Republic of Iran) for further evaluation. Computed tomography angiography revealed a large hepatic arteriovenous malformation with feeders originating from enlarged hepatic arteries and draining to enlarged hepatic veins. We performed a transcatheter embolization of the anomaly using ethylene vinyl alcohol copolymer (Onyx) during a single session. The cardiac function of the infant rapidly improved after the procedure. Over the 19 months of follow-up, his cardiac output remained stable and within the normal limits, and no complications were detected. Diagn Interv Radiol 2012; 18:231–235. Copyright © Turkish Society of Radiology 2012

DIR. US-guided percutaneous thrombin injection of postcatheterization pseudoaneurysms

This study retrospectively evaluated ultrasonography-guided (US-guided) percutaneous thrombin injection for the treatment of postcatheterization femoral and brachial artery pseudoaneurysms. Diagn Interv Radiol 2012; 18:319–325. Copyright © Turkish Society of Radiology 2012

DIR. Single-session percutaneous alcohol sclerotherapy for the treatment of isolated draining intrahepatic biliary duct in a five-month-old liver transplant recipient

The present paper describes the first reported successful use of a single session of percutaneous alcohol sclerotherapy for the treatment of an excluded segmental biliary duct in a fivemonth-old left lateral liver recipient. A concomitant stricture of the hepaticojejunostomy was also successfully treated using standard percutaneous balloon dilatation. The patient has remained in good general condition for the next 26 months. Diagn Interv Radiol 2012; 18:326–329. Copyright © Turkish Society of Radiology 2012

DIR. Diffuse unilateral pediatric arteriopathy: successful treatment with repeated angioplasty

We report a three-year-old girl exhibiting severe long-segment stenoses and occlusions with diffuse arterial involvement of the upper and lower extremities on the right side. The obstructive lesions, which caused atrophy of the right limb and chronic ulceration of the foot, were treated successfully with repeated percutaneous transluminal angioplasty. Obstructive peripheral arterial disease can cause growth retardation of the involved extremity, which can be salvaged by repeated endovascular therapy even in a small growing child. Diagn Interv Radiol 2012; 18:330–332. Copyryght © Turkish Society of Radiology 2012

SIR. Management of Pulmonary Arteriovenous Malformations

Pulmonary arteriovenous malformations are rare lesions with significant clinical complications. These lesions are commonly seen in patients with hereditary hemorrhagic telangiectasia (formerly Osler-Weber-Rendu syndrome). Interventional radiologists are a key part of the treatment team in this complex disease, and a thorough understanding of the disease process is critical to providing good patient care. In this article, the authors review the disease course and its association with hereditary hemorrhagic telangiectasia, discusses the clinical evaluation and treatment of these complex patients, and outlines complications and follow-up. Semin Intervent Radiol 2011;28:24–31. Copyright 2011 by Thieme Medical Publishers, Inc.

CVIR. Technical Solutions to Ensure Safe Yttrium-90 Radioembolization in Patients With Initial Extrahepatic Deposition of 99m Technetium–Albumin Macroaggregates

Purpose: To evaluate the incidence of extrahepatic deposition of technetium - 99m – labeled albumin macroaggregates(99mTc-MAA) after retreatment angiography,before yttrium-90 radioembolizaton (90Y-RE), and to report on technical solutions that can be used to ensure safe delivery of 90 Y-microspheres in patients with initial extrahepatic deposition. Cardiovasc Intervent Radiol (2011) 34:1074–1079. Copyright The Author(s) 2010. This article is published with open access at Springerlink.com

RADIOLOGY. Hepatic Resection versus Transarterial Lipiodol Chemoembolization as the Initial Treatment for Large, Multiple, and Resectable Hepatocellular Carcinomas: A Prospective Nonrandomized Analysis

To compare the survival outcomes between hepatic resection and transarterial lipiodol chemoembolization (TACE) used as the initial treatment in patients with large (5 cm), multiple, and resectable hepatocellular carcinomas. Radiology: Volume 259: Number 1—April 2011. Copyright RSNA, 2011.

RADIOLOGY. Prostate Cancer Ablation with Transrectal High-Intensity Focused Ultrasound: Assessment of Tissue Destruction with Contrast-enhanced US

Purpose: To assess contrast material–enhanced ultrasonographic (US) findings seen after high-intensity focused ultrasound (HIFU) ablation of prostate cancer and correlate the US findings with post-HIFU biopsy findings. Radiology: Volume 259: Number 2—May 2011. Copyright RSNA 2011. radiology.rsna.org

RADIOLOGY. Nonenhanced MR Angiography of the Hand with Flow-Sensitive Dephasing–prepared Balanced SSFP Sequence: Initial Experience with Systemic Sclerosis

Purpose: To compare the image quality and degree of vessel narrowing at fl ow-sensitive dephasing (FSD) magnetic resonance (MR) angiography of the hands with those at contrast material– Materials and Methods: enhanced MR angiography of the hands in patients with systemic sclerosis. Copyright RSNA 2011. Radiology: Volume 259: Number 1—April 2011. radiology.rsna.org

SEMINARS IN INTERVENTIONAL RADIOLOGY. Endovascular Management of Acute Upper Extremity Deep Venous Thrombosis and the Use of Superior Vena Cava Filters

SEMINARS IN INTERVENTIONAL RADIOLOGY. Endovascular Stent Grafts in Urgent Blunt and Penetrating Thoracic Aortic Trauma

A traumatic thoracic aortic injury is fatal in the majority of cases. Surviving the aortic injury in addition to the myriad of associated trauma requires comprehensive medical management from many medical services. Balancing these services and coordinating the medical care requires free and open communication between services. Although one might assume a thoracic aortic injury takes precedence over other injuries, an organized plan of care in which the morbidity of the injury as well as the consequences of treatment of each injury helps provide an appropriate “rank order” in the treatment process. A patient with a thoracic aortic injury can be observed for several days while additional injuries are treated, as long as appropriate blood pressure controls are observed. The treatment order for multiple injuries must be reevaluated on a regular basis to adjust for changes in the overall clinical condition. This rank order to treatment and scheduled treatment plan allows for appropriate imaging, evaluation, and coordination of services in preparation for the placement of a thoracic aortic stent graft. SEMINARS IN INTERVENTIONAL RADIOLOGY/VOLUME 28, NUMBER 1 2011. Semin Intervent Radiol 2011;28:98–106. Copyright © 2011 by Thieme Medical Publishers, Inc.